Table 4.
Summary of policy actions to support strategies for COVID-19 vaccine roll out in refugees and migrants (adapted from91,102,106)
| √ Advocate for countries that are getting vaccines from COVAX and other sources, to explicitly include marginalized populations. Include refugees and migrants in all national, provincial and local contingency, prevention and response plans and interventions. √ Advocate for information systems to capture vaccination coverage data for refugees and migrants, while ensuring data protection. √ Advocate for inclusion and non-discriminatory access of refugees and migrants to public health services. √ Firewalls should be put in place to shield migrants in irregular situations from the possible transfer of their personal data to immigration authorities and the risk of facing immigration enforcement measures when they attempt to access healthcare services, including COVID-19 immunization. √ Research and plan appropriate communication on access to vaccinations in collaboration with communities themselves or local actors. Multiple communication strategies will be needed to address the different motivations and social and cultural practices behind vaccine acceptance and preferred communication channels. Diversify communication tools and format, and simplify messages; ensuring to test messages with target group. √ Strengthen the capacity of healthcare providers to identify opportunities to promote vaccination among refugees and migrants. Advocate for mobile vaccination points, expanded hours for vaccination services, increased mobilization of volunteer steward/vaccinator support services. √ Given the importance of primary healthcare services for refugee and migrant populations, consider advocating for primary health centres (PHCs) to be used as accredited vaccination centres, provided access would not lead to deportation. √ Ensure refugees and migrants receive precise information on vaccine side effects, due to their limited access to health providers for follow-up questions and services. √ Educate healthcare and frontline workers on how refugees and migrants can be stigmatized and encourage community action to prevent or mitigate stigma, particularly within vaccination points and health centres. √ Improve training and awareness of healthcare workers and other frontline works on the needs and cultural, religious and social perspectives of refugees and migrants. Involve the host community to defuse any potential conflict (vaccine nationalism discourse). √ Mobilize refugees and migrant-led organizations, and networks to have a meaningful role in COVID-19 response and vaccination rollout plans from their inception. If national healthcare workers are prioritized as part of vaccination rollout plans, advocate for refugee, migrant and IDP healthcare workers to also be prioritized to support rollout plans. √ Partner with these groups to identify barriers, enablers and behavioural factors, preferred and trusted communication channels, preferred languages, misinformation and questions about vaccination uptake. √ Practise bottom-up approaches in developing community engagement strategies to emphasize the participation of the local community in developing initiatives and to ensure community ownership, commitment and accountability. Engage existing volunteer groups to use their creativity to raise awareness. √ National vaccination policies need to adopt innovative measures for hard-to-reach populations living in conflict or in secured areas, and where centralized vaccination policies and implementation strategies may face additional barriers to building trust. √ In humanitarian settings, it is important to enter systematically into new partnerships with humanitarian actors who are already active in missed or under-vaccinated communities and have experience implementing vaccination campaigns. √ The demand for vaccines for refugees and migrants needs to be carefully synchronized with supply availability to ensure that doses are not wasted. Demand should not outstrip a country’s ability to administer/deliver the doses it receives and allocates to avoid eroding public trust. |